[Surgical methods in anal and rectal prolapse].

Anal prolapse in adults is cured by the Milligan-Morgan procedure. Operation for the rectal prolapse has to repair procidentia, incontinence and obstipation. Procidentia and incontinence in low-risk patients are best repaired by abdominal rectopexy with or without plastic materials (Ripstein's procedure is preferred). Obstipation remains a long-term problem. Rectopexy in combination with sigmoid resection (Goldberg) improves obstipation, but there is leakage in 4% of the patients. The perineal approach offers no technical advantage. Perineal rectopexy, prolapse resection and Thiersch ring with modifications are preferred in high-risk cases. Posterior levator plastic improves remaining incontinence.